Reducing Resistance to Essential Care

Care employees frequently face the dilemma of whether to continue to deliver care despite resistance, or temporarily withdraw and leave a care need unmet. Reducing Resistance to Essential Care (RREC) training provides clarity what care is essential and what care can be delayed until co-operation can be generated using different approaches.

The RREC programme was developed in 2014 and is greatly influenced by the wider NAPPI approach to Positive Behaviour Support since 1995. This course is part of the NAPPI curriculum that is certificated under the Restraint Reduction Network (RRN) Training Standards (2019).

Essential care, is care that can no longer be delayed, such as in a medical emergency. It is not essential to change an individual’s soiled clothing “now”, but it will become essential later. At a specific point our responsibility under a Duty of Care will mean it is essential “now”, due to the risk to the individual’s health.

Essential Care Box:

During training care employees will learn that they can be part of the problem, increasing resistance by ‘pushing’ an individual who is not ready to cooperate with their well-meaning request. Rigid organisational routines such as scheduled times for bathing can push an individual who is just not yet ready. Sometimes an individual is just not yet able to cooperate at the time when the care employees want them to. This could be due to the individual’s confusion or just that they do not want to have a bath in the morning.

Care employees also learn how to gauge the level of resistance, understanding the difference between five specific levels and the result of applying pressure. To avoid this outcome, training introduces an effective approach to generate cooperation and avoids resistance wherever possible.

Pressure Gauge:

The time between identifying a need for personal care and that need becoming essential, is the time to work on reducing the individual’s resistance to the care task. When care employees recognise how to avoid placing pressure on an individual, they are much better placed to support the individual and meet identified need safely, with minimal resistance.

Well trained employees, recognise resistance to their delivery of care, and are able to determine the urgency of specific care tasks. While care provided without resistance is our aim, we recognise that there are occasions when a further delay to care delivery would not be considered 'best interests’. These are the times when physical skills are required, this maybe Non-restrictive (Pre-positioning) or restrictive (Clinical Holding).